By Michelle Andrews
When the annual sign-up period for individual Obamacare coverage ended earlier this month, it meant that in general, people are locked into their plans for the year.
There are exceptions, however, for those who experience life changes such as marriage, the birth of a child or the loss of their job-based coverage.
The list of situations that trigger a special, 60-day enrollment period will get longer in April, when a new rule issued by the Department of Health and Human Services takes effect.
The rule’s additional circumstances include:
Losing a dependent or dependent status because of divorce, legal separation or death. This provision would enable someone who no longer needs family coverage, for example, to switch to single coverage. Although not required until 2017, exchanges are encouraged to offer this as soon as possible.
An increase in an individual’s income to the federal poverty level in states that haven’t expanded Medicaid to adults with incomes up to 138 percent of the federal poverty level ($16,243 in 2015).At that income level, the person could qualify for premium tax credits that are available for those with incomes between 100 and 400 percent of the poverty level to make marketplace coverage more affordable.Last year, such individuals could also qualify for a special enrollment period, “but we read this as a bit broader,” says Sarah Lueck, a senior policy analyst at the Center on Budget and Policy Priorities. Last year, “you had to have applied for Medicaid to qualify.” Now, that’s not necessary.
If a court order requires someone to provide health insurance, the coverage must be available the first day the court order takes effect.“It’s extremely important for ensuring the coverage of children,” says Dania Palanker, senior counsel at the National Women’s Law Center.
People who are currently enrolled in non-calendar year plans will qualify for a special enrollment period when that coverage ends, even if they could renew them.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
5 things to know about the court case challenging the health law – “On March 4, the justices will hear oral arguments in King v. Burwell, a case challenging the validity of tax subsidies helping millions of Americans buy health insurance if they don’t get it through an employer or the government. If the court rules against the Obama administration, those subsidies could be cut off for everyone in the three dozen states using healthcare.gov, the federal exchange website. A decision is expected by the end of June. Here are five things you should know about the case and its potential consequences:”
Attention, shoppers: Prices for 70 health care procedures now online! – “Buying health care in America is like shopping blindfolded at Macy’s and getting the bill months after you leave the store, economist Uwe Reinhardt likes to say. A tool that went online Wednesday is supposed to give patients a small peek at the products and prices before they open their wallets. Got a sore knee? Having a baby? Need a primary-care doctor? Shopping for an MRI scan?”
Trying to quit smoking? There’s an app for that. – “The state Department of Health is offering a smartphone app to help Washingtonians kick their tobacco habits, and the first 1,900 app downloads are free. SmartQuit follows a unique program created at Fred Hutchinson Cancer Research Center to help people become tobacco-free.”
New Mexico’s nurse hotline touted as a model for other states – “New Mexico’s advice line is free and has been used by nearly everyone in the state old enough to make a phone call – 1.5 million residents are registered in NurseAdvice line’s database, 75 percent of the state’s roughly 2 million residents. Using one well-published telephone number (877-725-2552), anyone in the state can reach a registered nurse who picks up the line in less than three minutes – no telephone tree and no talking to robots. Most nurses who answer calls work part-time in local hospitals or clinics. All but a few answer phone calls from their homes.”
Three new cases of measles have been confirmed in Las Vegas, in people believed infected by a contagious worker at an upscale MGM Grand Hotel and Casino seafood restaurant, Nevada public health officials said on Friday.
A team of scientists said on Friday they had found “robust evidence” that a condition called Chronic Fatigue Syndrome (CFS) is a biological as opposed to a psychological disorder, but some experts questioned the findings.
On March 4, the justices will hear oral arguments in King v. Burwell, a case challenging the validity of tax subsidies helping millions of Americans buy health insurance if they don’t get it through an employer or the government. If the court rules against the Obama administration, those subsidies could be cut off for everyone in the three dozen states using healthcare.gov, the federal exchange website. A decision is expected by the end of June.
Here are five things you should know about the case and its potential consequences:
1: This case does NOT challenge the constitutionality of the health law. Continue reading →
From the US Centers for Disease Control and Prevention
Receiving medical care abroad can be risky. Learn about the risks and how to minimize them.
Going Abroad for Medical Care
“Medical tourism” refers to traveling to another country for medical care. It’s estimated that up to 750,000 US residents travel abroad for care each year.
Many people who travel for care do so because treatment is much cheaper in another country.
In addition, a large number of medical tourists are immigrants to the United States returning to their home country for care. The most common procedures that people undergo on medical tourism trips include cosmetic surgery, dentistry, and heart surgery.
Risks of Medical Tourism
The specific risks of medical tourism depend on the area being visited and the procedures performed, but some general issues have been identified: Continue reading →
President Barack Obama’s controversial executive action on immigration has highlighted a thorny health care issue for states: Potentially millions of immigrants could legally stay here and work, but still lack health insurance.
Unauthorized immigrants have limited access to health care coverage, and the president’s action likely will make them ineligible for most Medicaid services and bar them from purchasing insurance on the federal and state exchanges created under the Affordable Care Act (ACA).
Some states have sought to solve the problem for low-income immigrants with separate state-funded insurance programs. Those that have not are wrestling with the consequences of a population that is going without routine care, which can drive up costs when preventable illnesses become serious health emergencies.
Millions of immigrants could legally stay here and work, but still lack health insurance.
Treating kidney disease as an emergency condition, for instance, costs almost five times what it would with routine care denied to unauthorized immigrants, according to a Baylor College of Medicine study published by the Texas Medical Association last year.
Unauthorized immigrants without health insurance present other problems for states. In Maryland, for instance, state attorneys face cases of criminally insane defendants who are no longer deportable but can’t get the follow-up care required for release into the community. Continue reading →
The $1.3 billion that the United States government has spent since 2005 encouraging Africans to avoid AIDS by practicing abstinence and fidelity did not measurably change sexual behavior and was largely wasted, according to a study presented on the last day of an AIDS conference in Seattle.
Former Arizona county sheriff Richard Mack, a fierce opponent of Obamacare and a leader in the “constitutional sheriff” movement, is struggling to pay his medical bills after he and his wife each faced serious illnesses. The former sheriff and his wife do not have health insurance and started a GoFundMe campaign to solicit donations from family and friends to cover the costs of their medical care.
Sports fans risk having their hearing ruined by deliberate attempts to increase stadium noise and they need to start seeing earplugs as something cool, the World Health
Organization said on Friday. Shelly Chadha, a WHO expert on preventing deafness, said some U.S. sporting crowds consider breaking noise levels as an achievement, and cited a 136.6 decibel world record claimed by Seattle Seahawks fans in 2013.
“Anybody who is exposed to 136 dB for even a minute is going to face some consequences,” she told a news conference.
The cost of healthcare premiums could rise as much 779 percent if the Supreme Court erases ObamaCare subsidies in a majority of states this year, according to a new study.
A victory for the plaintiffs in King v. Burwell would erase subsidies in 37 states using HealthCare.gov, causing premiums to spike an average of 255 percent, according to new research by the nonpartisan group Avalere Health.
The percentage of people under age 65 living in a household reporting problems paying medical bills in the past year decreased from 21.3% (56.5 million) in 2011 to 17.8% (47.7 million) in 2014, according to a CDC report.